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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">akusherstvo</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics, Gynecology and Reproduction</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство, Гинекология и Репродукция</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7347</issn><issn pub-type="epub">2500-3194</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2313-7347.2019.13.1.050-062</article-id><article-id custom-type="elpub" pub-id-type="custom">akusherstvo-553</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW ARTICLE</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НАУЧНЫЙ ОБЗОР</subject></subj-group></article-categories><title-group><article-title>Postpartum anal incontinence</article-title><trans-title-group xml:lang="ru"><trans-title>Послеродовая анальная инконтнненцня</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3246-7452</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Петрушин</surname><given-names>А. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Petrushin</surname><given-names>A. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Петрушин Александр Леонидович - кандидат медицинских наук, заведующий хирургическим отделением.</p><p>164600 Архангельская область, село Карпогоры, ул. Ленина, д. 47.</p><p>Тел.: +7(921)0767329.</p></bio><bio xml:lang="en"><p>Alexander L. Petrushin - PhD, Head of Surgery, AR Karpogory CDH.</p><p>47 Lenina St, Karpogory, Arkhangelsk Region 164600.</p><p>Теl.: +7(921)0767329.</p></bio><email xlink:type="simple">petrushin.59@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9801-5782</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Прялухина</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Pryalukhina</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Прялухина Анастасия Владимировна - врач акушер-гинеколог.</p><p>164600 Архангельская область, село Карпогоры, ул. Ленина, д. 47.</p><p>Тел.: +7(911)5954550.</p></bio><bio xml:lang="en"><p>Anastasiya V. Pryalukhina - Obstetrician-gynecologist, AR Karpogory CDH.</p><p>47 Lenina St, Karpogory, Arkhangelsk Region 164600.</p><p>Теl.: +7(911)5954550.</p></bio><email xlink:type="simple">lemehova_anastasiya@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБУЗ Архангельской области «Карпогорская центральная районная больница»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Karpogory Central Regional Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>15</day><month>05</month><year>2019</year></pub-date><volume>13</volume><issue>1</issue><fpage>50</fpage><lpage>62</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Petrushin A.L., Pryalukhina A.V., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Петрушин А.Л., Прялухина А.В.</copyright-holder><copyright-holder xml:lang="en">Petrushin A.L., Pryalukhina A.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.gynecology.su/jour/article/view/553">https://www.gynecology.su/jour/article/view/553</self-uri><abstract><p>Postpartum anal incontinence is a complex disorder that develops mainly in young women and negatively affects their social and professional activity. The aim of this review is to summarize the available literature and current concepts on the etiology, pathogenesis, diagnosis and treatment of postpartum anal incontinence. The prevalence of postpartum anal incontinence varies from 13 to 39 %. The risk factors include vaginal delivery, the use of instrumental methods, age, body mass index &gt; 30, delivery-associated perineal tears, incontinence during pregnancy and smoking. The role of episiotomy in anal incontinence is not clear, some authors note a high risk of median episiotomy compared with mid-lateral one. Diagnosis of anal incontinence is mainly based on clinical examination and history data. The most informative imaging modality is endoanal ultrasound. Treatment of anal incontinence should begin with diet correction and medications for stool control. The efficacy of various treatment programs directed to strengthening the pelvic floor and anal sphincter muscles is controversial and needs further study. Surgical treatment is indicated if the conservative therapy is unsuccessful; the most common methods are sphincteroplasty and electroneuromodulation of the sacral plexus branches. Primary prevention measures for postpartum anal incontinence should focus on eliminating or reducing the risk factors. Special training programs for obstetricians can significantly reduce the number of perineal tears and their severity, as well as reduce the need in obstetric forceps. Secondary prevention steps include the correct choice of the first and subsequent deliveries in women with an increased risk.</p></abstract><trans-abstract xml:lang="ru"><p>Послеродовая анальная инконтиненция (АИ) является комплексной патологией, развивается в основном у молодых женщин и негативно влияет на их социальную и профессиональная активность. Цель настоящего обзора: обобщение и систематизация имеющихся литературных данных и представление современных взглядов на этиологию, патогенез, диагностику и лечение послеродовой АИ. Распространенность послеродовой АИ варьирует от 13 до 39 %. Факторами риска являются вагинальные роды, использование инструментальных методов, возраст, индекс массы тела более 30, разрывы промежности в родах, наличие инконтиненции во время беременности и курение. Роль эпизиотомии в развитии инконтиненции продолжает дискутироваться, ряд авторов отмечают высокий риск срединной эпизиотомии по сравнению со срединно-латеральной. Диагностика АИ в основном базируется на анамнестических данных и данных клинического обследования. Из визуализирующих методов наиболее ценным является эндоанальное УЗИ. Лечение АИ следует начинать с диеты и медикаментозной терапии, направленных на регуляцию стула. Эффективность различных лечебных программ, направленных на укрепление мышц тазового дна и анальных сфинктеров, неоднозначна и нуждается в дальнейшем изучении. Хирургическое лечение показано при отсутствии эффекта от консервативной терапии, наиболее распространенными методами являются сфинктеропластика и электронейромодуляция ветвей крестцового сплетения. Первичная профилактика послеродовой АИ направлена на исключение или уменьшение факторов риска. Внедрение обучающих программ для акушеров позволяет значительно уменьшить количество разрывов промежности и их тяжесть, а также сократить использование акушерских щипцов. Вторичная профилактика касается выбора способа первичных и последующих родов у пациенток с повышенным риском.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>послеродовая анальная инконтиненция</kwd><kwd>анальное недержание</kwd><kwd>повреждения анальных сфинктеров</kwd><kwd>послеродовые осложнения</kwd><kwd>анальная дисфункция</kwd></kwd-group><kwd-group xml:lang="en"><kwd>postpartum anal incontinence</kwd><kwd>anal incontinence</kwd><kwd>anal sphincter injuries</kwd><kwd>postpartum complications</kwd><kwd>anal dysfunction</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Abramowitz L. Complications analedurant la grossesse et le post-partum. POSTU. 2014;1-10. 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